Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?

Zambia has implemented a number of financing and organizational reforms since the 1990s aimed at increasing efficiency, enhancing equity, and improving health outcomes. This study reviews the distributional impact of these health reforms on enhancing equity at the regional level and for different so...

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Main Authors:	Chitah, Bona Mukosha, Chansa, Collins, Kaonga, Oliver, Workie, Netsanet Walelign
Format:	Journal Article
Published:	Taylor and Francis 2019
Subjects:	BENEFIT INCIDENCE ANALYSIS EQUITY PUBLIC EXPENDITURE RESOURCE ALLOCATION HEALTH EXPENDITURE HEALTH SERVICES POVERTY ALLEVIATION INEQUALITY
Online Access:	http://hdl.handle.net/10986/31144

id	okr-10986-31144
recordtype	oai_dc
spelling	okr-10986-311442021-05-25T10:54:36Z Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited? Chitah, Bona Mukosha Chansa, Collins Kaonga, Oliver Workie, Netsanet Walelign BENEFIT INCIDENCE ANALYSIS EQUITY PUBLIC EXPENDITURE RESOURCE ALLOCATION HEALTH EXPENDITURE HEALTH SERVICES POVERTY ALLEVIATION INEQUALITY Zambia has implemented a number of financing and organizational reforms since the 1990s aimed at increasing efficiency, enhancing equity, and improving health outcomes. This study reviews the distributional impact of these health reforms on enhancing equity at the regional level and for different socioeconomic groups. Data from three nationally representative household surveys were collected, and a benefit incidence analysis was conducted to determine the distributional impact over the period 2010–2015. The results show that distribution of subsidies and utilization of outpatient services at public health facilities in Zambia has consistently been in favor of urban provinces. Further, distribution of health subsidies across the ten provinces in Zambia does not correspond to reported illnesses in each province. The study also shows that utilization of outpatient services at public (hospitals and health centers) and private health facilities is generally in favor of the rich, and utilization of both inpatient and outpatient services at public and private health facilities benefits the rich more than the poor. And although the results show a pro-poor redistribution of benefits across income groups in 2015 compared to 2010 whereby the poorest two income groups received more than a 20% share of benefits in each quintile, the benefits were still lower than their health needs. This is contrary to the richest two income groups whose share of benefits was higher than their health needs in both 2010 and 2015. The study concludes that Zambia has not yet fully attained its long-term health reform vision of “equity of access to quality health care” despite years of successive health reforms. The study calls for the Zambian government to complement strategies on financial risk protection with deliberate supply- and demand-side actions in order to enhance equity. Improvements in long- and short-term planning and regular monitoring and evaluation are critical. 2019-01-11T17:50:38Z 2019-01-11T17:50:38Z 2018-11-05 Journal Article Health Systems & Reform 2328-8604 http://hdl.handle.net/10986/31144 CC BY 4.0 http://creativecommons.org/licenses/by/4.0 World Bank Taylor and Francis Publications & Research :: Journal Article Publications & Research Africa Zambia
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	BENEFIT INCIDENCE ANALYSIS EQUITY PUBLIC EXPENDITURE RESOURCE ALLOCATION HEALTH EXPENDITURE HEALTH SERVICES POVERTY ALLEVIATION INEQUALITY
spellingShingle	BENEFIT INCIDENCE ANALYSIS EQUITY PUBLIC EXPENDITURE RESOURCE ALLOCATION HEALTH EXPENDITURE HEALTH SERVICES POVERTY ALLEVIATION INEQUALITY Chitah, Bona Mukosha Chansa, Collins Kaonga, Oliver Workie, Netsanet Walelign Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?
geographic_facet	Africa Zambia
description	Zambia has implemented a number of financing and organizational reforms since the 1990s aimed at increasing efficiency, enhancing equity, and improving health outcomes. This study reviews the distributional impact of these health reforms on enhancing equity at the regional level and for different socioeconomic groups. Data from three nationally representative household surveys were collected, and a benefit incidence analysis was conducted to determine the distributional impact over the period 2010–2015. The results show that distribution of subsidies and utilization of outpatient services at public health facilities in Zambia has consistently been in favor of urban provinces. Further, distribution of health subsidies across the ten provinces in Zambia does not correspond to reported illnesses in each province. The study also shows that utilization of outpatient services at public (hospitals and health centers) and private health facilities is generally in favor of the rich, and utilization of both inpatient and outpatient services at public and private health facilities benefits the rich more than the poor. And although the results show a pro-poor redistribution of benefits across income groups in 2015 compared to 2010 whereby the poorest two income groups received more than a 20% share of benefits in each quintile, the benefits were still lower than their health needs. This is contrary to the richest two income groups whose share of benefits was higher than their health needs in both 2010 and 2015. The study concludes that Zambia has not yet fully attained its long-term health reform vision of “equity of access to quality health care” despite years of successive health reforms. The study calls for the Zambian government to complement strategies on financial risk protection with deliberate supply- and demand-side actions in order to enhance equity. Improvements in long- and short-term planning and regular monitoring and evaluation are critical.
format	Journal Article
author	Chitah, Bona Mukosha Chansa, Collins Kaonga, Oliver Workie, Netsanet Walelign
author_facet	Chitah, Bona Mukosha Chansa, Collins Kaonga, Oliver Workie, Netsanet Walelign
author_sort	Chitah, Bona Mukosha
title	Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?
title_short	Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?
title_full	Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?
title_fullStr	Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?
title_full_unstemmed	Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?
title_sort	myriad of health care financing reforms in zambia : have the poor benefited?
publisher	Taylor and Francis
publishDate	2019
url	http://hdl.handle.net/10986/31144
_version_	1764473641825730560

Myriad of Health Care Financing Reforms in Zambia : Have the Poor Benefited?

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